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13 Cards in this Set
- Front
- Back
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what's landsteiner's rule, and what kinds of donors are best for BLOOD and which are best for PLASMA?
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you make what you ain't - meaning that O people make anti A and anti B antibodies.
also note that AB+ and AB - are the UNIVERSAL PLASMA DONORS - they make absolutely no antibodies, which would normally be present in the plasma, so it's great to use. |
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what's the most common time for blood mixing between two people?
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pregnancy and birth
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what's the difference between a type and screen, and a type and match?
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type and screen is the "might need blood" concept - patient's blood is kept in the lab and analyzed, should blood MATCHING be necessary.
if you definitely need blood, Type and Match is done - patient is given the same blood tests, also the donors RBCs are tested with patient serum to make sure, AND THE BLOOD IS RESERVED FOR THEM until a physician releases the units. remember: it's VERY IMPORTANT to screen the patient's AB's against the donor's BLOOD to make sure no bad reactions happen. |
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giving a unit of red cells - what can you expect to happen with the patient's lab values? when not to give?
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the crit should go up 2/3%
the Hb should go up a point. don't give for volume expansion, to enhance wound healing, or to make someone feel better. note - don't let someone's crit get below 21, or their Hb get below 7. |
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platelet transfusion - what is a platelet count to shoot for, how much can you expect it to go up with a unit, how is it stored...?
what do you not give platelets for? |
platelets are left at room temperature, last for 5 days, and must be agitated
platelet count shouldn't get below 20,000, OLD IDEA - now know that 7000 can be tolerated. - therapy should be aimed at getting it up to at least 50,000. Give if production down, dysfunctionup a random unit can be assumed to provide 5-10,000 increase. generally can give 1 unit per 10kg of patient weight. DON'T GIVE if ITP or TTP, unless massive bleeding is happening. |
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fresh frozen plasma - what is it for? how much will it bring this up? what lab values indicate that FFP should be given?
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fresh frozen plasma, immediately think about clotting factors. it has all of them.
one unit should increase any given factor up to 2 to 3% (just like the crit with RBC transfusion). given often in liver disease (these people don't make enough clotting factors). a PT > 18 seconds or a PTT >50 seconds. Or if your coagulation factors are below 25% (remember that most factors are kept in excess and need be present only at 20% or so to function). given to counteract warfarin, after big transfusion, or multi-factor clotting deficiencies. can be used with TTP/HUS here. |
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when do you not give FFP?
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again, not for volume expansion (risk of infection transmission). Also not to get clotting factors to perfect livers - can't replace the liver for this. Only correct profound clotting factor deficiencies.
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what's cryoprecipitate? when to give?
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as you thaw FFP, scraping off the milky white stuff. Given specifically for LOW FIBRIONGEN disorders.
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what white blood cells do we transfuse, what's the procedure, what are the risks?
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granulocytes can be useful for helping people FIGHT FUNGAL INFECTIONS, but beyond this, don't transfuse WBC's. No good use.
can cause febrile reactions, HLA alloimmunization, GVHD (90% fatal, rapid onset), and viral/bacterial contamination. DON'T FORGET TRALI. Can 'leukoreduce' components, also irradiate components |
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when do we irradiate components? when do we NOT? what components are NOT irradiated?
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for premies, for immunocompromised patients/marrow receipients, hodgkin's, intrauterine transfusions, if PATIENTS ARE GETTING DONATION FROM CLOSE RELATIVE or HLA matched donors,
don't irradiate FFP/cryo, factor concentrates. Don't do it for full term kids, aplastic anemia, solid tumor patients. |
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Screenings - what do we check for in the bank?
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ABO/Rh, random antibodies.
Syphillis HIV I and II elisa. HCV elisa HBsAG HBsAb HTLV HIV/HCV/WNV NAT bacterial contamination of platelets. |
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what are the disease risk ratios for HIV, HCV, HTLV< and HBV?
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HIV is 1 in 2 or 3 million, probably a lot less.
HCV is 1 in 2 million. HTLV1 is 1:647000 HBV is 1:137,000 SO - know that the riskiest factor is possible HBV infection. |
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What is TRALI?
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50% of the post-transfusion related deaths happen from this. Listed as a risk factor, especially when giving WBC's to a patient.
Transfusion Related Acute Lung Injury. Antibody mediated. Antibodies against HLA or some other such thing. Maybe release of granules from transfused WBC's cause increased perm of the alveoli = FLASH PULMONARY EDEMA. Happens in 1/5000 transfusions, between 5 and 10% fatal. avoid women donors who have had lots of kids, or women who've gotten previous donations - their Ab's are all fucked up. |
